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obtained for sanitary inspectors the desirability of employing health visitors should be considered. At
the same time, the Local Government Board was urged not to permit any further reduction .in the
sanitary staffs in the county.
In four of the six boroughs above referred to, improvement was made by the appointment of
health visitors, and at the end of the year the conditions in the other two boroughs were under consideration.
During the early part of the year, complaints were received as to non.removal of house refuse in
the Metropolitan Borough of St. Pancras, and as to difficulties experienced with regard to the removal of
trade refuse particularly in West London. These difficulties apparently arose from shortage of labour,
but similar failure to remove house refuse was not found to exist in London generally. There were, however,
for a time, considerable accumulations at the various wharves, due, primarily, to the difficulty of
obtaining barges. The conditions in St. Pancras were attributed to shortage of stokers at the destructor
works. The Council entered into correspondence with the borough council on the matter, and improvement
was affected during the summer months, but at the end of the year the trouble was again
becoming serious.
National Insurance Acts, 1911.13.—Treatment of Tuberculosis.
As in 1915, the work of the Council in respect of the treatment of tuberculosis, was confined
within the limits existing at the commencement of the war. The arrangements for dispensary treatment
are in the hands of the metropolitan borough councils and the Council continued its grant of 25
per cent. of the net expenditure incurred by them in respect of uninsured persons. Schemes are in
operation in 26 boroughs (including the City of London), and in another borough a scheme
has been conditionally approved, but the work had not yet commenced. Under the approved schemes,
municipal dispensaries have been provided in 8 cases, and in the remaining 18 cases, voluntary dispensaries
have been utilised. There are further 3 voluntary dispensaries at work in Stepney. Authority
was renewed for the use of 231 children's beds and 100 adult beds in voluntary institutions at the cost
of the Council, and for the acceptance of such beds as were available in the institutions of the Metropolitan
Asylums Board, the cost of the latter beds being borne by that Board. Particulars
as to the number of children treated under the scheme and the institutions in which they
were accommodated are given in the section of this report dealing with the school medical service. The
following statement shows the number of adults treated during the year and the number remaining
under treatment on 31st December, 1916:—
Name of institution.
Total number treated,
including patients
under treatment,
on 1st January, 1916.
No of patients under
treatment on 31st
December, 1916.
I.—Voluntary Institutions.
Brompton Hospital and Frimley Sanatorium
Maltings Farm, Sanatorium
National Sanatorium, Bournemouth
National Sanatorium, Ventnor
Grosvenor Sanatorium
Metropolitan Hospital and Cranbrook Convalescent Home
Royal Sea Bathing Hospital, Margate
Eversfield Chest Hospital, St. Leonards
St. Catherine's Home, Ramsgate
City of London Chest Hospital, Victoria Park
London General Hospitals
205
59
8
15
6
3
10
1
1
7
37
57
9
2
2
1
1
7
1
6
II.—M.A.B. Institutions.
Winchmore Hill Sanatorium (Women)
Downs Sanatorium (Men)
Total number of adult persons treated under scheme
218
36
588*
16
4
106
^Included in the numbers given under Brompton and other hospitals, 21 patients were subsequently transferred
to one or other of the sanatoria given in the list. Allowance has been made for this in the totals.
By the extension of the facilities afforded by the Metropolitan Asylums Board the Council has
been enabled to provide for a limited number of advanced cases. 27 women and 4 children have thus
been sent to St. George's Home, Milman Street, Chelsea, and 3 men to a special section allotted for
advanced cases at Downs Sanatorium. At the end of the year 14 women and one child were under
treatment.
Reference was made in last year's report to the fact that the Council was endeavouring to appoint,
where possible, committees known as Interim Tuberculosis Care Committees in connection with each
tuberculosis dispensary, with the object of bringing together the various local agencies engaged in
ameliorating the lot of tuberculous persons in the areas served by the dispensaries, and of ensuring
that'suitable.after care and employment are obtained following institutional treatment; the intention